Depression in children who have not been diagnosed or treated properly may develop into a chronic disease that will recur in lifelong attacks, said Dr. Silvana Fenig, director of the division of psychological medicine at Petah Tikva’s Schneider Children’s Medical Center on the occasion of World Suicide Prevention Day to be held on September 10.
“Every year, there are about 250 visits to emergency rooms involving suicide attempts. It is very important to raise parents’ awareness of the importance of early detection of depression among children and adolescents. The earlier the disease is diagnosed, the better the chances of recovery and the prevention of complications,” she said.
The term depression describes a state of mind characterized by feelings of sadness, unhappiness and despair. Most people experience temporary depression at some point in their lives.
Depression affects not only adults, but also children and adolescents. Depression in children and youth is not a passing phase or part of normal mood swings in adolescence, but a serious and fatal disease that can be identified and affects millions of children under the age of 18 in Israel and around the world.
About 2% to 3% of elementary- school children (one in each classroom) and about 8% of adolescents (two to three in each class) suffer from depression.
Until the age of 13, the prevalence among boys and girls is the same, and then the prevalence among girls is three times higher than among boys.
Depression, like anxiety, is a mental disorder defined as an internalized problem. In depression and anxiety, the child suffers but does not necessarily reveal his or her suffering to family members, friends or teachers. This is in contrast to external problems such as hyperactivity and behavioral disorders, which are visible and burdensome to the social environment and can therefore be detected quickly and treated.
Prof. Alan Apter, a world expert on depression and suicide among children and adolescents who runs the Schneider Children’s Research Center, noted: “The complications that can develop from depression that is not treated at an early age are deterioration in school and dropping out, drug and alcohol abuse, eating disorders, social problems and even the risk of suicide. In 80% of cases in which help was involved, there was improvement within a few weeks, but without proper treatment the signs of depression may continue to worsen to the point of suicidal risk.”
At Schneider, psychiatrists and psychologists offer combined therapy – psychological, environmental and pharmacological.
The treatment method is cognitive behavioral therapy. In this method, treatment does not go into the causes of depression, but rather gives the child tools to cope with it and the consequences, Apter explained.
Children with depression are treated at Schneider as part of an individual mood-management workshop, where treatment extends the time between attacks and identifies precursors to prevent the next attack. On the behavioral level, the child is encouraged to gradually return to the activities he enjoyed before the crisis and to the previous level of functioning, both scholastically and socially. He or she is encouraged to engage in sports regularly, as this activity causes the secretion of natural opiates in the brain which improve mood.
Working with the child may also involve learning different skills such as social skills and time management that will enable him or her better cope in situations that cause distress.
During the workshop, the child receives assignments to perform at home – follow-up logs of events that cause mood swings, including the identification of thoughts and feelings that have arisen in these situations, and an attempt to create positive thoughts and to practice skills learned in the workshop.
At the same time, and as an integral part of the therapeutic system, parents are involved as key partners in caring for the child, providing them with tools for coping with the entire family and guiding them on the way to provide support. They also involve the broader environment of the child, such as the school, in order to help create a supportive atmosphere that is adapted to the individual needs of each child.
Meanwhile, the Health Ministry will next week hold a Jerusalem conference called “Choose Life” for 120 Orthodox rabbis in the community on preventing suicide. The conference is being organized by the Barkai Center for Practical Rabbinic and Community Development in Modiin.
Ashkenazi Chief Rabbi David Lau will speak along with professionals in the field, giving rabbis the tools to refer people to appropriate authorities when there is a suspicion of suicidal tendencies.